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Assessors office(1st Floor).
Assessor's map and lot nu bpr Q Q
Conservation(4th Floor):
Board of Health(3rd floor): b t.: • �: � EF.`�
Sewage Permit number 3- ��In 1 ` .' �:
Engineering Department(3rd floor):/ �� c • ` �"� _ � �"� °° �a�°'
House number
Definitive Plan Approved by Planning Bdard 6 11,,;,/ 19 \�
APPLICATIONS PROCESSED 8:30-93n.A.M:and 1:00-2:00 P.M.only z-
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TOWN OF BARNSTABLE `��
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ILD ! Iv�(�J � �c�
i
TYPE OF CONSTRUCTIONamaa(y� 19
t �O
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TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location L4)PAA A
Proposed Use
Zoning District Fire District
Name of Owner I Address
Name of Builder �Q— Address_
Name of Architect _fh Address
Number of Rooms /1910lioundation
Exterior Roofing
Floors Interior
Heating re L _ V Plumbing �u F_
Fireplace �i5 t `
p � -� Approximate Cost I S-01 050
Area
Diagram of Lot and Building with Dimensions Fee ����, —
� Lam, ti
vvl
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.
Nam
�t /'Vl•!�'Q �S
Construction Si ipervisor's License 64*3
AITTANIEMI, RICHARD
Na- 36256 Permit For 2 Story
Sin le Family
Location. ��� �aex--busy , rJ
West Barnstable _-~ '-• / - - �f -
Owner Richard Aittaniam-
� Frame - ,-_ .� % %� s.� � •.,
Type of Construction
Plot Lot
Permit Granted October 26 f 19 q'i
Date of Inspection: )
Frame 19
Insulation 1.9•
Fireplace _'� 19�- --- .,�- - - ,, i `,-�'L__< '•' ��,
_ Date Completed ;19
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DATE 19 PERMIT N0.
_ANT "` ADDRESS
(NO.) (STREET) (CONTR'S UCE`NW))
ling �..: . _ .r )., C1WE Z�_
NUMBER OF
PERMIT TO (_; STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
hattr'liuon.1 way. Nr_4C I)i1�...J i.�.i:J-,-� ZONING lit
AT (LOCATION) —.— --- DISTRICT
(NO.) (VJA�(ijdt STREET)FJ
BETWEEN I AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
2UILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: S-wage #93-446
RHEA OR I(. _. .. !.. 15V�O�(� PERMIT
IOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET) `
JWNER ,
�:. •�..r. . e..c . cc •1J �.. ...,> -- BUILDING DE PT. ``, .f � /•- ': �' � / � I
:ADDRESS BY F
"HIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR
PERMANENTLY, ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP-
PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED
FROM THE DEPARTMENT OF PUBLIC*WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
Cc ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
'VSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
. - ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND
I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MEMBERS(RE ADY TO LATH). FINAL INSPECTION HAS BEEN MADE.
3. FINAL INSPECTION BEFORE
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
/ l
.)
HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT
?—7
2 HEALTH
OTHER aV SITE PLAN REVIEW APPROVAL
I
WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE
TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN
CONSTRUCTION. I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION.
1 -
r�THIS FORM APPROVED BY THE COMMISSIONER OF REVENUE COMMONWEALTH OF MASSACHUSETTS
TOWN OF BARNSTABLE NOTICE OF
TAX RATE OFFICE OF COLLECTOR OF TAXES
PER$1,000 GENERAL DISTRICT TOTAL REAL ESTATE TAX
_ ... `-�• I� �` ��,( �"� `+ ++=I`t i i r � � + FISCAL YEAR ENDING
i RESIDENTIAL 1 ; j L. . y ;'r�i iy ri, PATRICIA A.�ACKEA,CCLL AR(5FWA J UNE 30, 1994
OPEN SPACE 2 ;J„.;;.� . ;i 9 iV A Based upon assessments as of January 1,1993 your REAL ESTATE tax
COMMERCIAL 3 for the fiscal year commencing July 1, 1993 and ending June 30,1994
INDUSTRIAL 4 e 5� ..i r �i�A upon the following described parcel of REAL ESTATE is as follows: •`''H'
9 P ACCOUNT X:
PROPERTY DESCRIPTION REAL ESTATE VALUES SS S N LIENS
DESCRIPTION CLASS V i do AMOUNT
PARCEL ID:. < nS•`•':ts�sd� ?> »`:i::>:>::;:::;:;; CHECKLV)
... IL ..A!, a... � I: 1 'V �% I �U�i CASH O
. 72
"FOWN OF BARN
PER
T ii i i<:i I L:.. 1;: .i d N 2 I% I s J y j OU ECTOH OF TAX S
TOTAL FULL VALUE RESIDENTIAL TOTAL TAXABLE VALUE TOTAL TOWN TAX TOTAL DIST.TAX TOTAL ASSESSMENTS TOTAL TAX 6 SEE REVERSE SIDE .
EXEMPTION ASSESSMENTS FOR
! , r 0 ti 3,y „ ; r IMPORTANT INFORMATION
AYABLE NOVEMBER 1 1993 PAYABLE BY MAY 1ST 1994
TOWN TAX DISTRICT TAX ASSESSMENTS TOTAL TAX TOWN TAX DISTRICT TAX TOTAL TAX
OWNER 1/1/93 a 3 i f fv t, c° I s +� ';'i°i l i';J J SCHOLARSHIP FUND PAYABLE 11/01/93 PAYABLE 5/1/94
i T e A Tc. j♦ iti rt''! r j <S J _I.TOTAL PAYMENT DUE
h.b f N ti 1 L t i♦ :.� .I C L.L.A2.AMT. CONTRIBUTION i (PAYMENTS)
h 1i fi tt.00 a.00 $S.00 61aoo ones (AMN
1, A'r(v S 3 A-L M ? h " :`t;.. ❑ ❑ ❑ ❑ ❑ (CHGS.A FEES)
(C ECxAMOUNT10UNSMNTO001WRIMIM INTEREST
3. ADO ITEMS 1 8 2 AN0
All payments must be made to:Tam of Bamslable PAY TOTAL AMOUNT S
Mall to Collectors Office,P.O.Box 1360TC,Hyannis,MA 02601 SEE El4CLOSED NOTICE • •' •
Office Hours:Monday—Friday 830 AM—430 PM
Roquired payment not made by November 1,or May 1 are subject to Interest at 14%per annum ', %'� / rj 'i �: • j ,;
Itorr,the first day of the preceding month. YOUR COPY
I -
AI TTANIEMI WA Y
231. 65.
0 58. 97 � ,
�O�A•AZ o
� oG g7. 3f tz �
LOT 2
a 47370t S. F. m
0
A 32•g9 410. 55
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; THE ENTIRE LOCUS IS SHOWN IN FLOOD
ZONE "C" ON FIRM PANEL 250001 0011 D.
PAUL
i; RYLL
'4r PLOT PLAN - LOT 2
THE FOUNDA TION SHOWN ON THIS PL AN WAS L OCA TED AI T TANIEMI WA Y AND
BY AN-INSTRUMENT SURVEY ON 9114193 AND
EXISTS ON THE GROUND AS SHOWN. - HIGH STREET, BARNSTABLE, MA
SCALE I " = 50 ' SEPTEMSER 15, 1993
5-�s-93 EAGLE SUR11EEYING W ENGINEERING, INC.
DATE PROFESSIONAL LAND EYOR 441 ROUTE 130, SANDWICH, M_ A
' PROJECT NUMBER 93-086
PNE`N E �N Application to
1 T 4 3- V?
�PNS�ENtPb�kpN,N�H
6PE Np lS o O
Old Kings Highway Regional Historic District Coma
.�V r
. 1993
in the Town of Barnstable for a
AWN OF BARNSTABLE
CERTIFICATE OF APPROPRIATENESSOW HIgHWAYL�l
Application is hereby made, iri triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,
Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs
accompanying this application for:
CHECK CATEGORIES THAT APPLY:
1. Exterior Building Constructi n: , New B ilding ❑ Addition ❑ Alteration
Indicate type of building: [House (Nye Garage ❑ Commercial
❑ Other
2. Exterior Painting: ❑ '
3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign
4. Structure: ❑ Fence ❑ Wall ❑ 'Flagpole , ❑ Other
(Please read other side for explanation and requirements). ✓f / q
TYPE OR PRINT LEGIBLY ► DATE
ADDRESS OF PROPOSED WORK _a�S t'Tl(O� bu- ASSESSORS MAP NO. `x0
OWNER 4 Dfl APE ASSESSORS LOT N0.
HOME ADDRESS �ti �O•�pC �j?jQ - �• TEL. NO.
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public
street or way. (Attach additional sheet if necessary).
MAiJIP
mimp
AGENT OR CONTRACTOR TEL. NO. �-8Z2�
ADDRESS ''
DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8,other side), including
materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed
locations of new signs. (Attach additional sheet, if necessary).
Signed
Owner-Conttrraccto • gen
Space below line for Committee use.
Received by H.D.C. I q
D t The Certificate i by fiZ`J rri Date �` 3
D I Q 0
Time' ' _
By
Approved IMPORTANT: If Certificate is approved,approval is subject to the 10 day appeal period
provided in the Act.
Disapproved ❑
Form
OLD KING'S HIGHWAY HISTORIC DISTRICT
S p e c S h e e t
Foundation Type
Siding Type
C
Chimney Type -
: Color 'S •W
-------------
Roof Material,
• Color
Pitch ( �
------------
Windows �•t!(1VLfK ITJV -t-Yj�jm,
Size
Trim Color - -
Doors
Color �[A.
Shutters 1
Gutters
I
Deck
Garage Doors Vo: l•el
Color
Notes: Fill out completely, including measurements and materials/colors to be used.
Three copies of this ' fo= are required for. submittal of an application,,
along with three copies each of the plot plan, landscape plan and e
plans, when applicable. - levation
*Plot plan need not be "Certified", but should show all structures on the lot
to scale.
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Assessor's Office(1st floor) Map /V Lot ®/ -2 �'`'Permit#
(`Conservation Office(4th floor) '1 `���A 6::T�`xILDate Issued '7 yZ(o
Board of Health(3rd floor)(8:30-9:30/1:00-2:00) Vq4 7 `°Pere
�C Engineering Dept.(3rd floor) House# '
Plannin
BARfiSTABLE.
Definitive Plan Approved by Planning Board 19 SE e -�� F r usT BE
TOWN OF BARNSTABLE WITH-T ULL.5
Building Permit Application
Project ess_ 4 °Wa-o8 w r-1dt LJex
Village W e.S a s s -kA S 1,e % r
Owner �9 i C k-G A.It 4' cl Address 1 Q W o o d
Telephone SO 1 7 r /' �
Permit Request 0-vdi l )-2LK --� 2p'c. � 0 � /7� S--e
(�Iotal 1 Story Area(include 1 story garages&decks) 3 q square feet
Total 2 Story Area(total of 1st&2nd stories) square feet
Estimated Project Cost $ "'K/.SO O .
Zoning District F Flood Plain ` Water Protection
Lot Size ) A-C ev— Grandfathered ?
Zoning Board of Appeals Authorization Recorded
Current Use AXV�- Proposed Use RQC►^ea-4
Construction Type ?reS 4 vwe- -L J Crr, C
Commercial /gyp Residential
Dwelling Type: Single Family DC Two Family Multi-Family
Age of Existing Structure - y r• Basement Type: Finished
Historic House Unfinished
Old King's Highway Y P S
Number of Baths -3 No.of Bedrooms 3
Total Room Count(not including baths) l B First Floor
Heat Type and Fuel Q _`�nse�c�t�Z Central Air Fireplaces I
Garage: Detached. Other Detached Structures: Pool /trd
Attached `f Barn //d
None Sheds �p
Other /f
n Builder Information
Name C G J A , 144 n Telephone Number •3 o2 O/ t/ 7
Address 1 4 m o o d ti Ca w a v License# /�tj �P Q �.► h e
0266op" Home Improvement Contractor#
Worker's Compensation#
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
7�SIGNATURE r 4 DATE
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
- - FOR OFFICIAL USE ONLY
PERMIT NO. 9370
,
DATE ISSUED ' 7/2 6/915 - - -
MAP/PARCEL NO. 111 017
W: Barnstable.
ADDRESS r VILLAGE .
Rbhard & Diane C. Aittaniemi
OWNER r -
DATE OF INSPECTION:
FOUNDATION =
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: , . ROUGH FINAL
GAS: ROUGH" FINAL r
FINAL BUILDING
a
DATE CLOSED OUT 6 v
o +
ASSOCIATION PLAN NO.
j
3
THE FOLLOWING �
IS/ARE THE BEST
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QUALITY ORIGINALS)
m A
LI
DATA
Town of Barnstable
• ''> Old Kin 's• g Highway Historic District Commission
SPEC SHEET
FOUNDATION
SIDING TYPE COLOR
CHIMNEY TYPE COLOR
ROOF MATERIAL COLOR
PITCH
WINDOW SIZE
TRIM COLOR
DOORS COLOR
SHUTTERS
GUTTERS
DECK
GARAGE DOORS COLOR
NOTES: Fill out completely, including measurements and
materials/colors to be used. Three copies of this
form are required for submittal of an application,
along with three copies each of the plot plan,
landscape plan and elevation plans, . when
applicable. Plot plan need not be "Certified",
but should show all structures on the lot to
y
scale.
SPECSHT
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AI TTANIEMI WA Y
0
231. 65
58. 9 _ D. E_
�97.
o 3f
Goo 'o y
h. LOT 2 - rn
a 47370t S.F. m
2 . 71
A,21 • 09 55
41 0.
� THE ENTIRE LOCUS IS SHOWN IN FLOOD
-% ZONE C ON FIRM PANEL 250001 0011 D.
PAUL � 4.
•% Gn
• ?�: RYLL
32,4 y 4sJ
PLOT PLAN - LOT 2
THE FOUNDA TION SHOWN ON THIS PL AN WAS L OCA TED AI T TANIEMI WA Y AND
BY AN INSTRUMENT SURVEY ON 9/1 N/93 AND HIGH STREET, BARNSTABL E, MA _
EXISTS -ON THE GROUND AS SHOWN.
SCALE 1 " = 50 ' SEPTEMBER 15, 1993
-5; ,s,93 EAGLE SURVEYING G ENGINEERING, INC.
DA TE PROFESSIONAL LAND Se VEYOR 441 ROUTE 130, SANDWICH, MA
PROJECT NUMBER 93-086
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please print. . - .
DATE `7_" _ 9
JOB. LOCATION d VJ i K (/l� ✓ �P.J"� Q✓�5 �
Number Street address Section of town
"HOMEOWNER" ��\C `'��✓Cl .� i 2 r' e -ho 1-0IY7 .. ..Y_
Name
Home phone Work phone
PRESENT MAILING ADDRESS Q a Sri d
City town State Zip code
The current exemption for "homeowners" was extended to include owner-occupied
dwellings of six units or less and to allow such homeowners to engage an in-
dividual for hire who does not possess a license, provided that the owner
acts as supervisor.
DEFINITION OF HOMEOWNER:
Persons) who owns a parcel of land on which he/she resides or intends to re-
side, on which there is, or is intended to be, a one to six family dwelling,
attached or detached structures accessory to such use and/or farm structures.
A person who constructs more than one home in a two-year period shall not be
considered a homeowner. Such "homeowner" shall submit to the Building Officia
on a form acceptable to the Building Official, that he/she shall be responsibl
for all such work performed under the building permit. (Section 109. 1. 1)
The undersigned "homeowner" assumes .responsibility for compliance with the Sta
c
Building Code and other applicable odes, by-laws, rules and regulations.
The undersigned "homeowner" certifies that he/she understands the Town of
Barnstable Building Department minimum inspection procedures and requirements
and that he/she will comply wit said procedures and requirements.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Note: Three family dwellings 35, 000 cubic feet,. or larger, will be required
to comply with State Building Code Section 127. 0, Construction Control.
I
i
HOME OWNER' S EXEMPTION
The da e'state that: "Any Home Owner performing work for which a building
permit is required shall be exempt from the provisions of this section
(Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if
Home Owner engages a person (s) for hire to do such work, that such Home Owner
shall act as supervisor. "
Many Home Owners who use this exemption are unaware that they are assuming
the responsibilities of' a supervisor (see Appendix Q, Rules and Regulations
for licensing Construction Supervisors, Section 2. 15) . This lack of awarenes
often results in serious problems, particularly when the Home Owner hires
unlicensed persons. In this case our Board cannot proceed against the
inlicensed person as it would with licensed. Supervisor. The Home "dwner-' actin
as supervisor is ultimately responsible.
To ensure that the Home Owner is fully aware of his/her responsibilities, man
communities require, as part of the permit application, that the Home Owner
certify that- he/she understands the responsibilities of a supervisor.' On the
last page of this issue is a form currently used by several towns. You may
care to amend and adopt such a form/certification for use in your community.
The Town of.Barnstable
NAM• snru�sr�. •
�,$ Department of Health Safety and Environmental Services
116
�► Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-775-3344 Building Commissioner
For office use only
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
improvement, removal, demolition, or construction of an addition'to any pre-existing owner occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent
to such residence or building be done by registered contractors,with certain exceptions, along with other
requirements.
Type of Work: A J 8 1 •e ck -6 //00 S e-- Est. Cost—,7y,570 0,
Address of Work: 1 g t-J O C d w W A y tj es
O mer.Name:
Date of Permit Application:
I hereby,certifv that:
Registration is not required for the following reason(s):
Work excluded by law
Job under S1,000
Building not owner-ooarpied
X Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS
FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE
ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A
SIGNED UNDER PENALTIES OF PERJURY
I hcrcby apply for a permit as the agent of the owner:
• I
Date Contractor name Registration No.
OR
7 9
Date Owner's na4le
11102.!94 17:02 V617727 7122 DEPT IA'D ACCID 1�0
Jr; CotlunomvpaLt/L o/ YWa-6Jac1zccsetb
' ..U�arfinenL o��nt�friaL./tfcccd�nti
600 W-Jington.,�Ensaf
James J.Campbell &ton, Mamaehuolfi 02f f f
Commissioner
Workers' Compensation Insurance Affidavit
1, ic �-a A c, es� i
with a principal place of business at.-
do hereby certify under the pains and penalties of perjury, that:
() I am an employer providing workers' compensation coverage for my employees working on
this job.
Insurance Company Policy Number
() I am a sole proprietor and have no one working for me in any capacity.
() i am a sole proprietor, general contractor or homeowner (circle one) and have hired the
contractors listed below who have the following workers' compensation policies:
Contractor insurance Company/Policy Humber
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
I am a homeowner performing all the work myself.
I understand that a copy of&cis s=cement will be forvarded to the Office of InvestiSations of cite DTA for coverage verification and that hilure to secs"
coverages rec.ed under Section 23A of MGL 152 call lead to the ImposWon of criminal penalties cotsistine of a fine of up to S 1,500.00 and/or c
years' imprisemaent as well as civil penalties in the form cf a STOP WORK ORDER and a fine of SI00.00 a day against mc.
Signed this day of 19
Licensee/Permittee Building Department
Licensing Board
y Selectmens Office
Health Department
TO. VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375
ao� s oa6 ys
Town of Barnstable *Permit#
Expires 6 months from issue date
a Regulatory Services Fee /S_O .
• saiwsreatS,
' AW
Richard V.Scali,Interim Director
6sA s��
Building Division X-PRESS PERMIT
Tom Perry,CBO,Building Commissioner
200 Main Street,Hyannis,MA 02601 MAY 0 8 2015
Office: 508-862-4038 U8=9�'®
www.town.barnstable.ma.us TOWN OF BA RR����CF�:�TTpp R�
-60
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address l`T G�/�ol�L�a� l/t/aY /J r-1 S'1 61
Residential Value of Work 1: -—Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address
blt"l 13
Contractor's Name e �rr Telephone Number
Home Improvement Contractor License#(if applicable),/dad Email: Oe 7e1-@
Construction Supervisor's License#(if applicable)_ �� a ��G
❑Workman's Compensation Insurance
Check one:
,-I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Re uest(check box)
Lj Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
�] Replacement Windows/doors/sliders.U-Value a c? (maximum.35)#of windows 3
61
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the H me provement Contractors License&Construction Supervisors License is
require
SIGNATURE:
T:VGVIN_D1Building ChangeslEXPRESS PERNfinEXPRESS.doc
Revised 061313
Unrestricted-Buildings of any use group which
contain less than 35,000 cubic feet.(991M )Of
enclosed space.
Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
For DPS Licensing information visit: vvww.Mass.Gov/DPS
Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
Construction Supervisor "" {
License: CS-062830 .;
PETER E JOHNS9N - 1
7 PENELOPE M
COTUIT MA 0205
I �
Expiration
Commissioner 08/29/2015
(glie WpowvmoazweaN opaclureCGi " I
License or registrahoti valid_for individul use only
�. •. Office of Consumer Affairs&Business Regulation before tl a expiration date. If found return to
OME IMPROVEMENT CONTRACTOR
egistration:. ,. 027g5 Type: Office of;Consumer Affairs and Business Regulation
- 10 Park Plaza-Suite 5170
Expiration:_-7(2/2016:- Individual Boston,MA02116
-- _ ----�
f = 7.
PETER EDWARD JOHNS,Nt"ems=r
may. = i I•Y 1. .
Peter Johnson =, �
7 PENELOPE LANE
COTUIT,MA 02635 "`-' Undersecretary. i Not valid without signature
i d
i
i
s
The Commonwealth of Massachusetts
Department of Indusoial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
tvsvtr.mass.gmldia
Workers' Compensation Insurance Affidavit: Builders/ContractorslElectizcians/Plumbers
Applicant Information Please Print Iggibly
Name(Business/Organizatiowindividoly
Address: �o1C ri/lp .r
City/StatelZip: �7� �e� Phone#:
Are you an employer?Check the appropriate boa: Type of project(required):
1.❑ I am a employer with 4. n I am a general contractor and I
employees(full and/or r part-time).* have hired the sub-contractors 6. New construction
2.4 I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g_ ❑Demolition
working for me in any capacity. employees and have workers' g ❑Building addition
[No workers'comp.insurance comp.insurance.
required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions
myself [No workers'comp. right of exemption per MGL 12.❑Roof repairs
insurance required.]r c. 152, §1(4),and we have no
employees.[No workers' 13.0 Other
comp.insurance required.]
•Any apphcaw that checks box#1 must also fill out the section below showing their workers'compensation policy information-
7 Homeowners who submit this affidavit indicating they are doing all work and that hire outside contractors must submit a new affidavit indicating such.
=Contractors that check this box must attached an additional sheet showing the name of the sub•couttactors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'camp.policy number.
I am an employer that is prosMug tworkers'compensation insurance for nit'employees. Beloit'is the policy and job site
itrfornradot.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c.. 152 can lead to the imposition of criminal penalties of a
fine up to S1,500.00 andlor one-year imprisonment,as well as civdi penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for in trance coverage verification.
1 do hereby certify and. pains and penaUies of perjury that the information protdEle abov.is true and correct
Si tore: Date �Gl
Phone M �/� �p7 3 -?G S
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
-- - 6
I
a .
MA
1639. 'Town of BarnstBarnstableA��
6p" Regulatory Services
Richard V.Scali,Interim Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
P
I, << Q' Quill�`—� ,as Owner of the subject property
hereby authorize �C l�uSo^ to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Signature of Owner Date
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
TAKEVIN Mudding Changes\EXPRESS PERM nEXPRESS.doc
Revised 061313
to
AI TTANIEMI WA Y
0
97 231. 65
p 5B ►_ D. E
__
,�� a2 �4
ir
o 97. 3f Cn
LOT 2
h 47370t S.F. cu
2 . 7t '
00
1 _
R'32. 99 410. 55
� 1
THE ENTIRE LOCUS IS SHOWN IN FLOOD
� ZONE "C" ON FIRM PANEL 250001 0011 D.
RYLL
PLOT PLAN LOT 2
THE FOUNDA T TON SHOWN ON THIS PL AN WAS L OCA TED AI T TANIEMI WA Y AND
BY AN INSTRUMENT SURVEY ON 9/14193 AND HIGH STREET, BARNSTABL E, MA' _
EXISTS ON THE GROUND AS SHOWN.
SCALE I ' = 50 ' SEPTEMBER 15, 1993
,s,93 EAGLE SURVEYING G ENGINEERING, INC.
DA TE PROFESSIONAL LAND SeVEYOR 441 ROUTE .130, SANDWICH, MA
PROJECT NUMBER 93-086
�2c,
j`� _ _..
-fie
y 'iY
. Y
z
z
�o
Ftwr Town of Barnstable
ble Permit#
Erpires 6 mon e Jr s dare
,. Regulatory Services Fee
awmsrtisr.s,
1619- ��� Thomas F. Geiler, Director
$�rF1 MAC A
Building Division
Tom Perry, CBO, Building Commissioner
200 Main Street, Hyannis, MA 02601
www,town.b ams tab le.ma.us
Office: 509-862-403 8 Fax.508-790-623 0
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
-7 Not Yalirl w lliour Red X-Press Imprint
Map/parcel Number 1 � ( v
Property - d d ress I V l� �
ER'Residential Value of Work . Minimum fee of$35.00 for work under S6000.00
Owner's Name & Address a,
Contractor's Narne Ok�Cll C DO(- C-br\9+CLAt,4---L, 14
(��- �✓`�-�r
Telephone Number
Home Improvement Contractor License#(if applicable) /q
Construction Supervisor's License#{(if applicable) �q
❑Workman's Compensation Insurance MAR 2 8 2012
Check: one:
❑ I am a sole proprietor
[) J,4iMth?Homeowner TOWN OF BARNSTABLE
01 have Worker's Compensation Insurance
Insurance Company Name 11 -�/`S 'v ` (� ►�1 YYl f f�
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request (check box)
Re-roof(hurricane nailed) (stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
#of doors
❑ Replacement Wind ows/doors/sliders. U-V (maximum.35)#of windows
*Where required: Issuance of this permit does not exempt corn iance with other town department regulations,i.e.Historic.Conservation,etc.
***Note: Pf"'erty Owne must sign it erty Owner Letter of Permission.
"A copy of th Home Imp'r91ve t Contractors License & Constr
require uction Supervisors License is
SI ZE:
GNATUI �
r)A WPrn rc%FnRMSlbuitdinP n fnr-c%PYPACCC 4 f
J
r� The Commonwealth of Massachusetts
Department of Industrial Accidents
office of Investigations
600 Washington Street
Boston,MA 02111
1vwty.mass.gov/dia
Workers' Compensation Insurance ectriciansiplumbers
Affidavit:Builders/ContractorslEl Please Print Le b
licant Information ' 1 r
Name(Business/Otg�tiou/individual)_ `I'll (�Y� ► •� t�
Address. �'t5� O to 'p5-T)L3
Phone#:
City/State/Zip- Type of project(required):
Are yo employer?Check the appropriate box:
4
with • ❑I am a g contractor and I 6 New cconstruction1. I am a employer have hired the sub-contractors 7 ❑Remodeling
employees(full and/or p -time)-' listed on the attached sheet.
2.❑ I am a sole proprietor or
These sub-contractors have 8_ Demolition
ship and have no employees employees and have workers' 9. ❑Building addition
working for me in any capacity. comp.insurance-1 10.❑Electrical repairs or additions
[No workers'comp-insurance 5.0 We are a corporation and its airs or additions
required.] officers have exercised their 11.❑Plumbing rep
3.❑ I am a homeowner doing wOrk right of exemption per MGL 12.❑Roof repairs
myself.[No workers'comp- c.152,§1(4),and we have no 13 Other
insurance required.]j o workers'
employees.[N
coml insurance required-]
piny appficam that checks boil must also fill out the section below shaving theft wotitets'compensation policy information
• doing all work and then hire outside couttactors must submit a new affidavit indicating stub
I Homeovnms who submit this of idn in indicating�y trig sheet shoeing the name of the sab-contractors and state wbether of not those entities have
;Contractors that check this box mast attached an additional vide their honkers'comp.policy number.
employees. If the sub-contractors have employees,they emtst Pro
I am an employer that is provuhmg workers'compensation insurance for my enrp(oyees Below its IltepoLcy and job site
information.
Insurance Company Name: I I
(�C)u U Expiration Date:
Policy#or Self-ins.Lic.#:
' �� l Ili City/State/Z.ip-
Job Site Address: i I the li number and expiration date).
under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
Attach a copy of the workers'compensation policy declaration page(showing p°
Failure to secure coverage as requiredsonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
fine up to S1,500.00 and/or one-year impn of this statement may be forwarded to the Office of
of up to$250.00 a day a e triolato advised that a copy
Investigations o IA for c erage verification.
I do It certify and a gins d penalties of perjury that the information providedabove is tare and correct
/ Date.
Si tore:
b
official nse only: Do not write in this area,to be completed by city or town official
Permit/License#
City or Town-
Issuing Authority(circle one): ector 5.Plumbing Ltspector
1.Board of Health 2.Building Department 3.City
Clerk 4.Electrical InsP
6.Other Phone#
6
Contact Person:
Nov. 28. 2011-10:49AM—Palumbo Insurance No. 2479—P. 2
RightFax K2-2 11/22/2011 1:34:37 PM PAGE 3/003 Fax Server
ISSUE DATE
12WO11
vOts CICrtTIFIGTE IB 7GSVE31 AS A,YtATTER OF Dr omm47lON Ov Y AND COrwLRg NO RrGNM UPON 71d CY1Lffi1CATL 1r0IXnL D=
CERTD'TCA1%DOER NOT APYANATNELYORNEGATIVZLrA ALNk=r=NDDOltAI;MTIMCOVERAGEAFFORDEDBYTHEPOU=Z
WAOW.THM CERTIFICATE OF]NOW.WCE 1o018 NOT CONSTITUIEA CONTRACS BEINMEN THE IGSUIMGJN2V1trs(S),AVIHOR=D
REPRE-grMATM 910PRoMcm AND THE CERTIIRGATE HOLDER.
NPORTANT:If tho certificate holder Is an Ao0rTIONAL IN51.1RE0,the pollcyges)must be endorsed If SUBROGATION IS WAIVED,subject to the
terms and condhiohs of the poUcy,certain po0eiea may require an endolsemehf.A statement an this ceriNficate,does not confer rights to the
certificate holder in tlou of such endorsements).
PRODUCER CONTAGY
WILLIAM PALUMBO INS AGCY NAME:
PHO4527 FALMOUCH ROAD vx,n Fpk
ue
COTUIT.MA 02635 E L are No);
ADDRENE:
PRODUCER
CUSTOMER to!.
IMURED INS APPORDTWGCOVERAGE I`IA1C*
T L HITCHCOCK CONS'I RUCTION I11;StIRER A TRAV,DME CTASSIGMaKE
SERVICES INC INSURER B
55 LISA LAME
WEST BARNSTARLS,MA 02668 CNSY1R6It C
INSURER D
INSURER R
i.rSY.]uI1�Y F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
TW&J$TO CERTIFY THAT TRE POLICI!9 OF WOUR I CE LESTED 9LOW HAVE BFFN ISSUED TO TIMIMSURM NAMED ABOVE FOR THd POLICY PFALOD MOICA-aa.
N0TwRwTANDDa.,LhYREQrr0Anow,zEpmox O,vDrnaNOF Amy CO\7RACfOROTaRDOCm,0WT`Pn2PISPEGTTOWIIC8TII9cza=icAuvAYBB
f88L,EDOAMAYPffitTAIN.TZ9IWSVAAMATPO"WBYTHEPOLACI'S DESCRIBED HEREINI.S4VDTFC1'TDA1;.TB MMW.ECCLCS=SANDCOfMITWN®OBSUCH
FOLICIE&LEM SHOWN XATRAV1E BREN RIDtiCfO)frY PAID CLAldI3.
1W6I2 7TPEOFINS1lrAANCE ADDL SODR POIICVNMMBER POLICYY,�T POLICYEXP X1D T6
VOL DISR WVD
YfAfIII.TTY• BACROCCURMCE $
000)aa c+Ar.ascOFACLTAM1rY �Aa�wcr�nsarfs� S
. iR�Q{f<S ICI aercro=l
0 Cww MOB 0 OMM �D.E7O (AV ae I
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e?aaor�
0 AIL0wMMAAv= BODLYBTIOYY f
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0 SCrrbV=DAUT0a 9ROPEYTYDAACwE S
.erxa
0 MRMAMS S
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0
0 R7rcmuAD 'r CXAD/9S MADE AGGSZOME S
0 MUCTDII]: f
0 aersrrcw 1 s
WORJOIRS'COMPFNSATION WCSfATJT08t
A AND!]r0'LOYI'RRI,XXOMM
Y�!\
ANY PIIOPhhDElOArPAR'n�eFl
NIA 7pJtm-9966MS61 IIAA/LI 11AA112 EL RACBACMDWr
$100,000
pu�wanRrnftml
D Ass-6A 1160,000
YF8
if{fin.Arccbs ordMDFSCRI7II0�1 OF L�Yff�_P]LCY
oPERAMSUbdIeW 1500,000
n*�"m'n*—r'OP OP1Q:Aa0Rs2ocA'ri0R4/v>�Q.FS(1SDaAAgpgD roi,AdEidond RdipRQ gN�lt Itefbr�r0as�is regwe0
i9rsaEP4ACfSANrY PRIORC>3tltFicAT£E90ED Tp iTIIr CIITTITCATSBOLDBR AI'PLCMNC WCVXE.4 CO)61P COVBRAON
&HOULo ANY OF TNEABOV19 O63CpiBEb FOLICIEO SE CAHCELLSp eeFoAl•
THE EXPIRATION VATS THEREOF,NOTICE WILL 13E bP1 ERm IN
ACCORDANCE WITH THE PaUcY Pilovisions.
AURIDRISD REA0.nWAYM
woo _ t. _ R3wrrdov ofIr
_e
Office of Consumer Affairs and 2usiness Regulation
10 Park Plaza..- Suite 5170
Boston, Massacimsetts 02116
Home Improvement Coatrctor Registration
—.-- Registration: 165907
Type: Private Corporation
Expiration: 4/6/2012 Tr# 2954M
TL HITCHCOCK CONSTRUCTIOW-S �b
THEODORE HITCHCOCK
55 LISA LANE'
WEST BARSTABLE, MA 02668
Update Address and return card..Mark reason for change.
Address Renewal Employment Lost Card
IS-CA1 v 50M-W04-G10121r.
,per �fe�om�xa9w.eald a ./�aaaac/u�a�tta
Office of Consumer Affairs&B�, ess Regulation License or regish ation valid for individul use only
HOMEIMPROVEMENT CONTRACTOR before the expiration date. If found return to:
TTLTCHCOCKC-0
Registration:;r�65907 Type: Ofce of Consumer Affairs and Business Regubrtion
Expiration: 41612012 Private Corporation 10 Park Plaza-Suite 5170
Boston,MA 02U6
j-EIJ(�SERVICE INC.
THEODORE HITCHGOCi< "
55 LISA LANE �-
WEST BARSTABLE,'(i�A1,1�68'%I Undersecretary Not yah
ature
Nl:Lssachusetts-Department of Pubiic-Sateti-
Board of Building Re;uiations and Standards
� C�r=s�r,-rti�-S4I�7tais:�.T?azrral�,�Limns=
License: CS SL 99828
Restricted to: RF,WS
TED HITCHCOCK
55 LISA LANE ^` '
r:1
WEST BARNSTABLE, MA 02668 y
�y�� Expiration: 6/12012
Comrnic.i��rrcr Tr#: 99828
c
� I
4
THE Tom of Barnstable
Regulatory Services
awaxsTRLEi _
y Musa Thomas F.Geiler,Director.
s6s�
��� -
61 - Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.ba rnsta ble-ma.us
Office: 508-862-403.8 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
as Owner of the subject property
hereby authorize L— / I u(?Alr;�ta act on my behalf,
in all matters relative to work authorized by this building pertnit application for:
�Jo ; rJ
(Address of Job)
Signature of Owner Date
:�S v7 K /0 1-nd, ,e7
Print Name
If Property Owner is applying for permit please complete the Homeowners-License
Exemption Form on the reverse side.
--
._�
�^
��T.�L�'�%Gv
�/
�� �� ��
• �tME ip� The Town of Barnstable -
BARNSTABLE. • Department of Health Safety and Environmental Services
MASS.
039. Building Division
367 Main Street,Hyannis, MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Inspection Correction Notice
Type of InspectionG�
Location ill 1 Oo 17 I N,1� D, Permit Number 3 ��
Owner. Al1—rr Ky� 1 t�5M I Builder
One notice to remain on jobsite, one notice on file in Building Department.
The following items need correcting:
Q Ta ST H-P,\-oG 70 \W T H
Ped I'?e Ili L_ c a 200E1 hi� C9.
r i -fc C) ,Ct
Please call: 508-790-6227 for reeinspection.
Inspected by
Date �1 .
THE tp�`oa
TOWN OF BARNSTABLE
t DAaa9TAEL .'
'pp r6 q. �P ASL
MASSACHUSETTS
W` W
I Solid Fuel Stove Permit
DATE OF PPVLTION ..........v... 4 7......7.. ............ Fes. ISSUING PERMIT AW... ........
NAME (o ner) 1.,r� ..........� .% �Y.I.� /NAME (Installer) .....................�./..VIV&. .` ............................................
ADDRE .. . . ....... .................................... ..............l.N...i........... .� .... ADDRESS ...........................................................................................................................
STOVE TYPE .. ....1..11 ........................................................... CHIMNEY: NEW ........................ EXISTING ... ..
Manufacturer ........L�..,f�. lN. d.l............................................ CHIMNEY: Masonry .................. .................................................
Mass. Approval .....: .. ........................................................................................ CHIMNEY: Metal ...................................................................................................
This is to certify that the above installer has permission to stall a olid fuell b rning appliance at the listed
address in accordance with an application on file with the . . .. .-1-Dq..................7..2.0. 1. Fire Department,
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
Issued By: ...................
............................ ..................... Title .....••!.••.•..`............................. Date ......°1........ ...................
Permit to install expires 60 days after issue date
// / p? F-� ............... . . .1�1 ...............................................................................................
Stove ..1.. .........................................................................................
StoveClearance ............. .................................................................................................................................................................................................................................................
Floor .................�..�...................................................................................................................................................................................................................................................................................
SmokePipe ..............17.. .........................................................................................................................................................................................................................................................
SmokePipe Clearance .................4!!1 ...................................................................................................................................................................................................................................
Chimney ........................a�..�.:...................................................................................................................................................... ................................................................................................
SmokeDetector .......................... ;Ylnl .... ....... .............................................................................................
The undersigned hereby certifies that the installation of solid fuel burning stove and equipment made under au-
thority of permit dated ..... �� ,7 ......... has been made in accordance with provisions o io -e
of Massachusetts State Building Code now currently in effect and pertaining thereto
Installer
.� - -
INSTALLATION APPROVED ..........�f�(J.................... By ...... ...... ......................... .�.................................. Title R ........... :.....
date
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT
TOWN OF BARNSTABLE
DAMSTAn . Office of the Building Inspector
rMiu&
i639. �
Date June 29, 1995
Fee $10.00
Permit No. 131
PERMIT TO ERECT SIGN IS HEREBY
GRANTED TO Richard J. Aittaniemi N
DIBIA RIK'S MUSICAL INSTRUMENTS
LOCATION High Street (Windwood Wav) �*
West Barnstable, MA 62668
ANY VIOLATION OF THE SIGN LAW WILL CAUSE IMMEDIATE REVOCATION OF
THIS PERMIT
Buildin"w' Inspector
i
The Town of Barnstable permit no. 11L
Department of Health, Safety and Environmental Services
K M' = Building Division date d ,2 S
367 Main Street,Hyannis MA 02601
fee /o.Od
Application for Sign Permit
Applicant: c ✓d A f iQ-1 i' e Assessor's no.
Doing Business As: S g o S i c C, Telephone 5-08-36,�-.c '0 -5-
Sign Location (w
street/road: i s
Zoning District Old King's Ifighway District? yes_ no
Property Owner
Name: C ka d 7 /a 4e; a'~• ; Telephone SO 83 6 a-01 4 7 F►��
Address: 1 Q .(j o d i (11),,J VJ a Y Village ,g -ti-)rt S t e
Sign Contractor
Name: S C? Telephone
Address: Village
Description
Diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign
to be drawn on the reverse side of this application.
Is the sign to be electrified? yes no (Note: if yes, a wiring permit is required)
I hereby certify that I am the owner or that I have the authority of the owner to make application, that the
information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the
Town of Barnstable Zoning Ordinances.
Date Signature of Own r/Authorized Agent
Size (sq. ft.) Permit Fee
Sign Permit was approved: k_ disapproved:
Date Signature o uil ' Official
. 0�6
AI TTANIEMI WA Y
0
231. 65
9 D. E.
0� 2 ��
tz
I
97. 3f V
LOT 2 �o Qo .�
47370. S.F. m
2 . 7t '
R;2g . 99 55
�,32• 410. 1
, THE ENTIRE LOCUS IS SHOWN IN FLOOD
„ ,/ZONE . C ON FIRM PANEL 250001 0011 D.
rA`'L jc��•�
RYL
PLOT PLAN - LOT 2
THE FOUNDATION SHOWN ON THIS PLAN WAS L OCA TED AI T TAIVIEMI WA Y AND
BY AN INSTRUMENT SURtIEY ON 9114193 AND . HIGH STREET, BARNSTABL E, MA
I EXISTS ON THE GROUND AS SHOWN. SCALE 1 " = 50 ' SEPTEMBER 15, 1993
q f*L5-1 3 /�-7 EAGLE SURVEYING G ENGINEERING, INC.
DATE PROFESSIONAL LAND SeVEYOR 44.1 ROUTE 130, SANDWICH, MA
-086
PROJECT NUMBER 93
Application to
995 1 15
Old Kings Highway Regional Historic District Committee
in the Town of Barnstable for a
CERTIFICATE OF APPROPRIATENESS
Application is hereby made, id triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,
Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs
accompanying this application for:
CHECK CATEGORIES THAT APPLY:
1. Exterior Building Construction: ❑ New Building ❑ Addition ❑ Alteration
Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other
2 Exterior Painting:
3. Signs or Billboards: 0 New sign ❑ Existing sign ❑ Repainting existing sign
4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other
(Please read other side for explanation and requirements).
TYPE OR PRINT LEGIBLY DATE J f 9 r
ADDRESS OF PROPOSED WORK I �� e w -kd WC,y W Ra✓4 S•ASSESSORS MAP-NO. �
OWNER ASSESSORS LOT NO.
HOME ADDRESS 19 woz w 1 A Way Wes 4- /)gins 4elIt TEL NO. .3 6 d -01 y 7
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public
street or way. (Attach additional sheet if necessary).
A 1+-+Ci 1 02 9 S' /Y q Ca.,11 fti b fie.� 'm C,
GNie����tt���'e2Y 7 N. G SST w. �Q /'►S k; 51e /�G, oa-(nG�'
�t1Si �v�SlruGhu� Ca✓}� Uy ��IIG dJ.a�e � i ��1
AGENT OR CONTRACTOR TEL NO.
ADDRESS
DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done(see No. 8,other side), including
materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed
locations of new signs. (Attach additional sheet, if necessary).
�,•ts-�•✓cc+ i iy x Z S %g K- fzi bus
G DDDo
Signed
Owner-Contractor-Agent
Space below line for Committee use.
I cre�6bH,U.0
a
[Date ) I he C i toishere ► DateMAY 3 11995ime ) /
a
THY N OF BARNSTABLEOF
�..
Approved IMPORTANT: If Certificate.is approved, /roval Is su ect tot/e/l�O day appeal period
provided in the Act.
Disapproved ❑
e Tovvt►of Barnstable
Old King's Highway Historic District Commission
SPEC SHEET
FO ATION
SIDING TYPE COLOR
CHIMNEY TYPE CO
ROOF. MATERIAL COLOR
PITCH
WINDOW SIZE
TRIM COLOR !S I-Q k -black Le-Ye f_c twos} �
DOORS COLOR
SHUTTERS o
GUTTERS A/
11-1
DECK /~I
GARAGE DOORS COLOR
NOTES: Fill out completely, including measurements and
materials/colors to be used. Three copies of this
form are required for submittal of an application,
along with three copies each of the plot plan,
landscape plan and elevation plans, when
applicable. Plot plan need not be "Certified",
n but should show all structures on the lot to
D D o ,ut scale.
D
SPECSHT
i
MASSACHUSETTS
MAPS of
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h 5g• 97 �_ O. E__ ' � �
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I
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L
THE ENTIRE L OCUS IS SHOWN IN FLOOD
y- --` ZONE C ON FIRM PANEL 250001 0011 0.
Au
r. .t:.4.9
PLOT PLAN — LOT 2
THE FOUNOA TION SHOWN ON THIS PLAN WAS L OCA TED AI T TANIEMI WAY AND
BY AN INSTRUMENT SURVEY ON 9114193 'AND HIGH STREET, BARNSTABL E, MA
EXISTS ON THE GROUND AS SHOWN.
SCALE 1 " = 50 ' SEPTEMBER 15, 1993
5 EAGLE SURt/EYING G ENGINEERING, INC.
DATE PROFESSIONAL LAND SerlEYOR 441 ROUTE 130, SANDWICH, MA
PROJECT NUMBER 93-086
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